BEAR LAKE COMMUNITY HEALTH CENTER, INC. — NPI 1629309786 (Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) in GARDEN CITY, UT)

CMS-1500 Box 24J / 33a • NPI

1629309786

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207Q00000X (CMS 08)

Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)

Box 32 Service Location & ZIP+4

325 WEST LOGAN HIGHWAY, GARDEN CITY, UT, 84028-8001

✓ 9-Digit EDI 837 ZIP+4 (84028-8001)

Practice Phone & Referral Fax

(435) 946-3660

Fax: (435) 946-8215

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1629309786 (BEAR LAKE COMMUNITY HEALTH CENTER, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1629309786` (NPI-2 Organization / Facility)
Provider / Legal Name	BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Plain-English Specialty	Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: `207Q00000X` (Family Medicine)
Certifying / Licensing Body	American Board of Family Medicine (ABFM)
Practice Location Address	325 WEST LOGAN HIGHWAY, GARDEN CITY, UT, 84028-8001
Practice Telephone / Fax	Tel: (435) 946-3660 \| Fax: (435) 946-8215
Administrative Mailing Address	517 W 100 N STE 210, PROVIDENCE, UT, 84332-9826
Enumeration & Last Sync	Enumerated: 2010-01-28 \| CMS Record Updated: 2022-06-06
Authorized Official	JORGE GARCIA (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

325 WEST LOGAN HIGHWAY, GARDEN CITY, UT, 84028-8001

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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)

What Does Taxonomy Code 207Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 08 (Physician/Family Practice)
Certifying / Accrediting Authority: American Board of Family Medicine (ABFM)
Clinical Scope: Annual checkups, blood pressure and diabetes management, BMI and fatty liver screening, urinary tract infections, vaccinations, and continuity of care for the whole family.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BEAR LAKE COMMUNITY HEALTH CENTER, INC.)

Typical CPT / Diagnostic Procedures:

Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)

Common Therapeutic Classes:

Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: N/A \| License: `Verified` \| Primary: Secondary
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: N/A \| License: `Verified` \| Primary: Secondary
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: N/A \| License: `Verified` \| Primary: Secondary
`1223G0001X` — Dentist, General Practice Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: N/A \| License: `Verified` \| Primary: Secondary
`133V00000X` — Dietitian, Registered Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered	State: N/A \| License: `Verified` \| Primary: Secondary
`152W00000X` — Optometrist Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist	State: N/A \| License: `Verified` \| Primary: Secondary
`1835P1300X` — Pharmacist, Psychiatric Plain English: Licensed & Credentialed Pharmacist, Psychiatric	State: N/A \| License: `Verified` \| Primary: Secondary
`207V00000X` — Obstetrics & Gynecology Plain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`2084P0804X` — Psychiatry & Neurology, Child & Adolescent Psychiatry Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)	State: N/A \| License: `Verified` \| Primary: Secondary
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: N/A \| License: `Verified` \| Primary: Secondary
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: N/A \| License: `Verified` \| Primary: Secondary
`363LF0000X` — Nurse Practitioner, Family Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family	State: N/A \| License: `Verified` \| Primary: Secondary
`363LP0808X` — Nurse Practitioner, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health	State: N/A \| License: `Verified` \| Primary: Secondary
`207Q00000X` — Family Medicine Plain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

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BEAR LAKE COMMUNITY HEALTH CENTER, INC. (NPI #1629309786)